Merck Knows More about Zetia than They’re Telling Us

(or How I Learned To Stop Worrying and Love the Pharmaceutical Industry) I'd like to try to change the way you think about preventative medications. The goal of prescribing blood pressure-lowering medications is not to lower blood pressure.  The goal of prescribing cholesterol-lowering medications is not to lower cholesterol.  The goal of prescribing medications for osteoporosis (low bone density) is not to raise bone density.  Let me explain.  The goal of medications that low...
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Shocking Study: Pedometers Motivate People to Walk More

Last week's post generated many comments from you, and I appreciated them very much. With Thanksgiving approaching and New Year's resolutions around the corner many of us are reviewing our commitment to our exercise program (or realizing that for the last few months we've had no commitment and therefore no exercise program).  With this perfect timing, this issue of the Journal of the American Medical Association published a More

Neither Spinal Manipulation nor NSAIDs Help in Acute Low Back Pain

Acute low back pain is a very common problem, so one would think that we would already know how to treat it optimally.  Sadly, we don't. A study in this week's Lancet raised serious doubts about two of the most common therapies sought out by patients with low back pain: non-steroidal anti-inflammatory drugs (NSAIDs) and spinal manipulation.  The study received much coverage in t...
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Learning to Say “I’m Sorry”

Medical mistakes have been receiving a lot of attention in the last few years.  The number of patients injured due to medical mistakes, especially in hospitals, has caused pressure at every level of health care to reexamine how patients can be protected.  Many of these error prevention measures are technical -- computerized drug interaction checking, pharmacy algorithms to prevent dispensing medications to which the patient is allergic, redundant verification of critical pieces of information li...
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Steroids Help for Bell’s Palsy, Antivirals Don’t

Bell's palsy is a fairly common condition that causes the sudden paralysis of half of the face.  Effected people can't fully close the effected eye and have an asymmetric smile, since only one side of the mouth moves well.  The cause is unknown and has always assumed to be viral.  The symptoms slowly resolve over a few months. The accepted treatment has always been steroids and acyclovir (an anti-viral medication), each for about 10 days.  More

Statins Have Long-Lasting Benefits

The West of Scotland Study was a landmark in preventive medicine.  It was published in the early 1990s and was the first study to definitively show that statins (a family of cholesterol-lowering medicines) could prevent a first heart attack in people with high cholesterol.  It randomized over 6,000 middle-aged men with high cholesterol who had never had a heart attack to either pravastatin (Pravachol) or placebo.  In about 5 years of follow up, pravastatin clearly prevented heart attacks and sav...
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Chronic Lyme Disease Still on the Fiction Bookshelf

At any given time thousands of people feel unwell and are dissatisfied with the diagnoses offered them by their doctors.  They struggle to understand their illness and frequently form patient groups for mutual support.  Every few years a new diagnosis captures their attention and becomes the latest vogue illness, usually without any scientific evidence.  Even worse, unscrupulous doctors latch on to these fad diagnoses to promise cures to patients who are desperate for relief.  A few years ago th...
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Shocking News: Diabetics Should Exercise

This week's Annals of Internal Medicine has a very well designed study that examined the effect of exercise on patients with diabetes.  Previously sedentary diabetics were randomized to four groups:  one group was enrolled in an aerobic exercise program, a second group was enrolled in a resistance training program, a third group was enrolled in a program with both aerobic exercise and resistance training, and...
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